Welcome to M.V Hospital for Diabetes, established by late Prof. M.Viswanathan, Doyen of Diabetology in India in 1954 as a general hospital. In 1971 it became a hospital exclusively for Diabetes care. It has, at present,100 beds for the treatment of diabetes and its complications.

Monday, September 23, 2013

Weight gain is a common side effect for people who take insulin. However, controlling weight is possible and is also an important part of the overall diabetes management plan.

The connection between insulin and weight gain

Insulin allows glucose to enter the cells so that the level of blood glucose drops. However, if a person’s calorie intake is high and activity level is low, then there will be more calories than is needed to maintain a healthy weight, and body cells will get more glucose than they need.

Glucose that body cells don't use is stored as fat.

Weight gain may also be the result of other complex functions of insulin that are related to how cells use fats and proteins.

How to avoid weight gain while taking insulin

Eating healthy foods and staying physically active every day can help you prevent unwanted weight gain. The following tips can help you prevent weight gain:

1. Count calories. Consume foods that have lower calories. Use more fruits, vegetables and whole grains in the diet. Have a balanced meal each day. Cut down portion sizes, avoid second helpings and drink water instead of high-calorie drinks. Your dietitian will help you with meal planning methods.

2. Don't skip meals. Don't skip meals to lose weight. It decreases the body’s ability to use energy properly , and when a person is hungry they tend to eat the wrong type of foods. Skipping meals also causes large fluctuations in blood sugar levels. Three small meals a day with healthy snacks in between can result in better control of weight and blood glucose levels.

3. Be physically active. Physical activity burns calories. A reasonable goal for most adults is a minimum of 150 minutes a week of moderately intense aerobic activity — such as walking, bicycling, water aerobics, dancing or gardening — plus muscle-strengthening exercises at least two times a week. Get advice from the doctor about what you can do.

4. Take your insulin only as directed. Don't missor reduce your insulin dosages to prevent weight gain. Without enough insulin, blood glucose levels will rise — and so will the risk of diabetes complications.

Tuesday, September 10, 2013

-You can help prevent diabetes complications by understanding the importance of insulin in managing blood sugar, and the goals of insulin therapy.

The role of insulin in the body

Insulin keeps the level of blood glucose within the normal range. Carbohydrates are broken down into sugar and enter the bloodstream in the form of glucose which is the main source of energy for the body. Under normal conditions, the pancreas responds to this by producing insulin, which allows sugar to enter the tissues. Glucose which is not used is stored in the liver as glycogen. When insulin levels are low,such as in between meals, the liver converts glycogen into glucose and releases it into the bloodstream. This keeps blood sugar levels within the desired range.

In diabetes, the pancreas secretes no insulin, or produces too little insulin, or the body cannot use the insulin produced .The level of glucose in the bloodstream increases because it is unable to enter cells. If left untreated, high blood sugar can lead to complications such as blindness, nerve damage and kidney damage.

Insulin therapy

If your doctor recommends insulin therapy, take the recommendation seriously. Most people try to delay it as far as possible. Insulin therapy can help prevent diabetes complications by helping to keep blood glucose within the target range.

The goals of insulin therapy

In Type 1 diabetes, insulin therapy replaces the insulin the body is unable to produce.

Characteristics of Insulin

Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose.

Peaktime is the time during which insulin is at maximum strength in terms of lowering blood glucose.

Duration is how long insulin continues to lower blood glucose.

Types of Insulin

Rapid-acting insulin, such as insulin lispro, insulin aspart,or insulin glulisine , begins to work about 5 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours.

Regular or Short-acting insulin (human) usually reaches the bloodstream within 30 minutes after injection, peaks from 2 to 3 hours after injection, and is effective for approximately 3 to 6 hours.

Intermediate-acting insulin (human) generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 18 hours.

Long-acting insulin (ultralente) reaches the bloodstream 6 to 10 hours after injection and is usually effective for 20 to 24 hours. There are also two long-acting insulin analogues: glargine and detemir. They both tend to lower glucose levels fairly evenly over a 24-hour period with less of a peak of action than ultralente.

Premixed insulin is convenient for people whose blood glucose levels are stable on this combination.

Insulin Strength

All insulin is dissolved or suspended in liquidsand has different strengths. U-100, means it has 100 units of insulin per ml of fluid,and U-40 has 40 units of insulin per ml of fluid.Different countries use different types, so it is wise to carry sufficient reserves while traveling.

Using Insulin Therapy

There are several points to keep in mind when using insulin:

Method of taking the insulin

The dosage and timing

Selection of the appropriate insulin preparation depending on its 'speed of onset and duration of action'.

Adjusting dosage and timing to fit the amount of food one eats, when one eats and what one eats.

Adjusting dosage and timing to fit exercise.

Adjusting dosage, type, and timing during conditions such as increased stress or illness

Adjusting to individual differences in the absorption of insulin into the bloodstream when injected.

Even the best diabetic treatment with synthetic human insulin or even insulin analogs, however administered, cannot replicate the normal glucose control in the non-diabetic.

Making matters even more complicated is that glucose from some foods is absorbed faster or slower than the same amount of glucose in other foods.

In addition, fats and proteins delay absorption of glucose from carbohydrates which are eaten at the same time.

When you exercise the need for insulin is lowered even when all other factors remain the same, because working muscle has some ability to take up glucose without the help of insulin.

The beta cells of people without diabetes routinely and automatically manage this by continual glucose level monitoring and insulin release . A person with diabetes has to rely on a physicianor a diabetes educator and on his own individual experience. It is a continual balancing act for all people with diabetes, especially for those taking insulin.

Patients with insulin-dependent diabetes usually require a base level of insulin (basal insulin), as well as short-acting insulin to cover meals (bolus insulin). Maintaining the basal rate and the bolus rate is a continuous balancing act that people with insulin-dependent diabetes must manage each day. This is normally achieved through regular blood tests.

About Me

Dr. Vijay Viswanathan, Managing Director, M.V. Hospital for Diabetes and Diabetes Research Centre, Royapuram, Chennai, India, a WHO Collaborating Centre for Education, Research and Training in Diabetes.
Head of the WHO Collaborating Centre for Research, Education and Training in Diabetes.
MD in Internal Medicine and was awarded Gold medal in final MD examination.
Awarded Ph.D. in Medicine by Tamil Nadu Dr. M.G.R. Medical University, Madras on the study of Diabetic Nephropathy in Type 2 Diabetes.
Has published over 150 original articles in peer reviewed International and National journals especially on Diabetic kidney diseases and Prevention of foot Amputation in Diabetes.
Organized 5 International Conferences on diabetic foot.